Devon Dermatology Services, PC

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

Legal business name

DEVON DERMATOLOGY SERVICES, PC

Practice address

92 Lancaster Ave Ste 120
Devon, PA 19333-1378

Phone

(610) 989-2224

NPI assigned

Aug 31, 2021

Last updated

Jan 3, 2022By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Jordan V Wang, MDNPI 1699129924

Title

Owner

Phone

(610) 989-2224

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jordan Victor Wang, MD

  • Dermatology Physician
  • Devon, PA
  • NPI 1699129924
  Medicare reassignment Care Compare group NPD Authorized official
• Danielle M Dehoratius, M.D.

  • Procedural Dermatology Physician
  • Bryn Mawr, PA
  • NPI 1245346873
  Medicare reassignment Care Compare group NPD
• Stephanie Slaski, MMS, PA-C

  • Medical Physician Assistant
  • Devon, PA
  • NPI 1790182434
  Medicare reassignment Care Compare group

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1630368000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1641168000000",
    "number": "1700554235",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "92 LANCASTER AVE STE 120",
            "city": "DEVON",
            "state": "PA",
            "postal_code": "193331378"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "92 LANCASTER AVE STE 120",
            "city": "DEVON",
            "state": "PA",
            "postal_code": "193331378",
            "telephone_number": "610-989-2224"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEVON DERMATOLOGY SERVICES, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-08-31",
        "last_updated": "2022-01-03",
        "certification_date": "2022-01-03",
        "status": "A",
        "authorized_official_last_name": "WANG",
        "authorized_official_first_name": "JORDAN",
        "authorized_official_middle_name": "V",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "610-989-2224",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gerard P Davis, D.MIN
• Tamara Davis, RN
• Kristine B Decena, RN
• Delaware Valley Wound Care Specialists LLC
• Devereux Foundation
• Devon Family Practice LLP
• Devon Manor-Devon PA LLC (Devon Manor)
• Dine Monte Nido, LLC
• Theresa Christina Disipio
• Vincent James Distefano, MD

• Dermatology Physician in Devon, PA
• Providers in Devon, PA by specialty
• Dermatology Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.